바로가기메뉴

본문 바로가기 주메뉴 바로가기

Korean Journal of Clinical Psychology

정신장애인을 위한 직업재활

Vocational rehabilitation for persons with psychiatric disability?

초록

정신장애를 가진 사람들의 진정한 회복은 직업을 가짐으로서 만이 가능하다. 따라서 직업재활서비스는 정신장애인의 치료와 재활에 핵심적인 요소로 부각되고 있다. 대부분의 정신장애인은 취업을 하기를 원하고 있으며, 또한 적당한 지원을 받는다면 충분히 직업을 수행할 능력이 있다. 그러나 정신장애에 대한 편견과 제도상의 제약이 그들의 직업재활을 막고 있다. 이제 우리나라의 임상심리학자를 포함한 정신보건전문가들도 직업재활서비스를 제공해야 하는 상황에 이르렀다. 본 글의 목적은 정신보건 분야에서 직업재활이 활발하게 실천되기를 촉구하는 것이다. 먼저 정상인과 달리 정신장애인에게 직업이 주는 특별한 이득이 무엇인지를 알아봄으로써 직업의 중요성을 강조하였다. 또한 효과적인 직업재활프로그램의 방향을 모색하기 위하여 현재 직업재활접근법에서 쟁점이 되고 있는 문제들과 그 실제를 알아보았다. 더하여 임상심리학자가 직업재활전문가 역할을 해야 하고. 할 수 있는가를 논하였다. 끝으로 우리나라의 정신장애인 직업재활을 발전시키기 위한 몇 가지 과제를 제시하였다.

keywords
person with psychiatric disability, psychiatric rehabilitation, supported employment, vocational rehabilitation, person with psychiatric disability, psychiatric rehabilitation, supported employment, vocational rehabilitation, 정신장애인1), 정신재활, 지원고용, 직업재활정신질환은 장기간의 치료에도 불구하고 재발이 반복된다. 따라서 투병의 기간이 길어지면서 본인은 물론 가족도 지치고 희망을 잃게 된다. 이것은 정신질환이 다른 질병처럼 증상 자체만의 문제가 아니기 때문이다. 정신질환 증상을 가지는 것(손상단계)은 하나의 외상경험이며 후속적으로 개인에게 부정적인 영향을 끼쳐서 인생 전체를 바꾸어 놓는다. 그 진행과정을 살펴보면, 대부분의 경우 급성기에 약물복용을 하면서

Abstract

The true recovery of persons with psychiatric disability can be achieved only through work. Thus vocational rehabilitation services have been widely recognized as critical elements of both therapy and rehabilitation in the advanced countries. Most of persons with psychiatric disability desire to perform competitive jobs and also are able to do so with reasonable supports. However, the reality is that social prejudices and systematic restrictions exist as main obstacles to psychiatric vocational rehabilitation. Now it has arrived at the point that mental heath professionals including clinical psychologist have to provide the vocational rehabilitation. The aim of this article is to urge to be delivered vocational rehabilitation in mental health field of this country. First, the importance of work was highlighted in terms of the benefits work can provide uniquely for persons with psychiatric disability. Also theoretical and practical issues in the approaches of vocational rehabilitation were discussed to find an effective vocational programming. In addition, discussion was made about whether clinical psychologists should and could make a vocational rehabilitation professionals as their career. Finally, several impending tasks necessary for developing vocational rehabilitation for persons with psychiatric disability were suggested.

keywords
person with psychiatric disability, psychiatric rehabilitation, supported employment, vocational rehabilitation, person with psychiatric disability, psychiatric rehabilitation, supported employment, vocational rehabilitation, 정신장애인1), 정신재활, 지원고용, 직업재활정신질환은 장기간의 치료에도 불구하고 재발이 반복된다. 따라서 투병의 기간이 길어지면서 본인은 물론 가족도 지치고 희망을 잃게 된다. 이것은 정신질환이 다른 질병처럼 증상 자체만의 문제가 아니기 때문이다. 정신질환 증상을 가지는 것(손상단계)은 하나의 외상경험이며 후속적으로 개인에게 부정적인 영향을 끼쳐서 인생 전체를 바꾸어 놓는다. 그 진행과정을 살펴보면, 대부분의 경우 급성기에 약물복용을 하면서

참고문헌

1.

(2005) 정신장애인을 위한 직장편의,

2.

(2004) 정신장애인 직업재활을 위한 취업 전 교육프로그램의 효과, 계명대학교

3.

(2003) 정신장애인 고용주를 위한 안내서, 도서출판 정신재활

4.

(1996) 기능평가 재활정신의학의 진단,

5.

(2002) 정신장애인을 위한 지원고용 전략의 실제 선택, 자원, 전략의 실제, 도서출판 정신재활

6.

(2004) 정신장애인을 위한 취업 전 교육프로그램, 도서출판 정신재활

7.

(2001) 정신장애인 직업재할을 위한 기관간 연계방안 , 한국장애인고용촉지공단

8.

(2000) 정신장애인의 직업유지기간에 영향을 미치는 요인에 관한 연구, 이화여자대학교

9.

(2003) 사회복귀시설에서 정신장애우의 직업재활 , 한국장애인고용촉진공단 전북지사

10.

(1999) 정신분열병환자의 직업재활 성과의 예측요인에 관한 연구, 서울여자대학교

11.

(1999) 정신장애인을 위한 직업재활의 과제와 대책,

12.

(1995) An ethnographic study of coping strategies used by people with severe mental illness participating in supported employment,

13.

(2002) The relationship of clinical factors in environmental opportunities to social functioning in young adults with schizophrenia,

14.

(1979) The principles of psychiatric rehabilitation, University Park Press

15.

(1993) Recovery from mental illness The guiding vision of the mental health service system in the 1990s,

16.

(1994) Characteristics of people with psychiatric disability that are predictive entry into the rehabilitation process and successful employment,

17.

(1987) Supported employment for persons who are psychiatrically disabled,

18.

(2002) Psychiatric Rehabilitation, Center for Psychiatric Rehabilitation

19.

(1987) Assessment in psychiatric rehabilitation Handbook of measurement and evaluation in rehabilitation,

20.

(1984) Vocational rehabilitation of the psychiatrically disabled,

21.

(1984) Predicting the vocational capacity of the chronically mentally ill:Research and policy implications,

22.

(1986) The practice of psychiatric rehabilitation,

23.

(1995) Relationship between psychiatric symptomatology work skills and future vocational performance,

24.

(1995) Relating functional skills of severely metally ill clients to subjective and societal benefits,

25.

(2005) The long-term work experiences of persons with severe and persistent mental illness,

26.

(1998) Social correlates of competitive employments among people with severe mental illness,

27.

(1990) Community care of the seriously mentally ill:Counting problems and current issues,

28.

(1982) Fountain House Model of Psychiatric Rehabilitation,

29.

(1998) Job preferences of people with severe mental illness,

30.

(2001) Converting day treatment centers to supported employment programs in Rhode Island,

31.

(1994) Individual placement and support:A community mental health center approach to vocational rehabilitation,

32.

(2003) A working life for people with severe mental illness, Oxford University Press Inc.

33.

(1998) Job terminations among persons with severe mental illness participating in supported employment,

34.

(1996) Job preferences of clients with severe psychiatric disorders participating in supporter employment programs,

35.

(1995) Psychiatric symptoms and work performance among people with severe mental illness,

36.

(1996) Clinical benefits of paid work activity in schizophrenia,

37.

(1986) A comprehensive treatment programs for schizophrenia and chronic mental illness,

38.

(1990) Social skills training with schizophrenics:A meta-analytic evaluation,

39.

(1969) and vocational planning of schizophrenics Journal of Counseling Psychology,

40.

(1992) A kind word for sheltered workshop,

41.

(1992) Handbook of psychiatric rehabilitation,

42.

(2001) Implementing supported employment as an evidence-based practice,

43.

(1988) Vocational rehabilitation of persons with prolonged mental illness, Johns Hopkins University Press

44.

(1995) Accelerating entry into supported employment for persons with psychiatric disabilities,

45.

(1986) Accelerating entry into transitional employment in a psychosocial rehabilitation agency,

46.

(1997) An update on supported employment for persons with severe mental illness,

47.

(1993) Center for Psychiatric Rehabilitation,

48.

(1991) Vocational rehabilitation outcomes for persons with disabilities:An update,

49.

(2001) Does competitive employment improve nonvocational outcomes for people with severe mental illness ,

50.

(1993) Psychosocial functioning and subjective experience in schizophrenia,

51.

(1989) Understanding differences between mental health and vocational rehabilitation A key to increased cooperation,

52.

(2002) Quality of life benefits of paid work activity in schizophrenia,

53.

(2002) Job satisfaction and job success as moderators of the self-esteem of people with mental illness,

54.

(1992) Natural vocational supports for persons with severe mental illness Innovations in mental Health Services, Jossey-Bass

55.

(1995) Discriminant function analysis of competitive employment outcomes in a transitional employment program ,

56.

(2000) Vocational rehabilitation for persons with schizophrenia Recent research and implications for practice,

57.

(1994) Predicting community employment among persons with psychiatric disability:A logistic regression analysis,

58.

(1987) Where is the vocational in psychiatric rehabilitation,

59.

(1995) Wanted Champions of psychiatric rehabilitation,

60.

(1987) The choose-get-keep approach to supported employment,

61.

(1992) A psychiatric rehabilitation approach to supported employment, Jossey-Bass

62.

(1992) Chronic psychoses and rehabilitation:An ecological perspective,

63.

(1984) Functional assessment of psychiatrically disabled adults Implications of research finding for functional skills training Functional assessment in rehabilitation,

64.

(1982) Psychiatric rehabilitation as a deterrent to recidivism,

65.

(2002) Differences in job retention in a supported employment program Chinook Clubhouse,

66.

(1998) A brief history of the Individual Placement and Support Model,

67.

(2003) Recent research on vocational rehabilitation for persons with severe mental illness,

68.

(1999) A randomized clinical trial of supported employment for inner-city patients with severe mental disorders,

69.

(1996) The New Hampshire study of supperted employment for people with severe mental illnesses ,

70.

(1986) Inpatient psychosocial treatment of chronic schizophrenia:Negative effects and current guideline,

71.

(1992) Supported employment and the quality of life,

72.

(2000) Social cognitive theory of careers and individuals with serious mental health disorders,

73.

(1993) Reasonable accommodation for workers with serious mental illness,

74.

(1989) Supported employment for severely psychiatrically disabled persons,

75.

(1994) Assessment and planning in psychiatric rehabilitation Psychosocial assessment and treatment of persons with severe mental disorders,

76.

(1998) Predicting rehabilitation outcome among patients with schizophrenia,

77.

(1994) The critical element to sustaining competitive employment,

78.

(1999) Stigma and mystical thinking Barriers to vocational rehabilitation services for persons with severe mental illness,

79.

(1994) Contributions of psychologists to inpatient care of persons with chronic mental illness,

80.

(1992) Handbook of psychiatric rehabilitation,

81.

(1997) Disposition toward employment and perspectives on the employment process held by clients with psychiatric disabilities,

82.

(1996) What are the functional consequences of neurocognitive deficits in schizophrenia American Journal of Psychology,

83.

(1987) Toward an integration of the rehabilitation process The Journal of Nervous and Mental Disease,

84.

(2000) A rehabilitation counselor education program with a specialization in vocational rehabilitation of people with severe mental illness ,

85.

(2000) Psychiatric vocational rehabilitation Where are the customers' views?,

86.

(1988) Vocational evaluation with people who are psychiatrically disabled Results of a national survey,

87.

(1992) Correlations between psychiatric disabilities and vocational outcome,

88.

(1982) Former patients as volunteers in community agencies:A model work rehabilitation program,

89.

(1994) A community mental health center approach to vocational rehabilitation,

90.

(1995) Vocational rehabilitation in schizophrenia,

91.

(2002) Improving employment outcomes for persons with severe mental illness,

92.

(1995) Maximizing schizophrenia treatment outcomes A model for integration,

93.

(1995) Work performance over time for people with schizophrenia,

94.

(1995) Wisconsin card sorting test and work performance in schizophrenia,

95.

(1993) Work capacity in schizophrenia,

96.

(1998) Planning a statewise project to convert day treatment to supported employment,

97.

(1991) Supported employment outcomes for people with psychiatric disability Journal of Vocational Rehabilitation,

98.

(2001) Unique issues in assessing work function among individuals with psychiatric disabilities ,

99.

(2003) Identifying relationships between functional limitations and demographic characteristics of persons with psychiatric disabilities ,

100.

(2002) An investigation of reasonable workplace accommodations for people with psychiatric disabilities,

101.

(1998) The durability of supported employment effects,

102.

(1997) Neuropsychological assessments as an aid to psychosocial rehabilitation of severe mental disorders,

103.

(1997) Predicting employment outcomes for people with chronic psychiatric illness ,

104.

(1990) Reasonable accommodations for workers with psychiatric disabilities,

105.

(1990) Supported employment:New challenges for vocational evaluation,

106.

(1995) Predictors of work status and future work orientation in people with psychiatric disability,

107.

(1997) Recent advances in psychiatric rehabilitation for patients with severe mental illness,

108.

(2002) Beyond components Using fidelity scales to measure and assure choice in program implementation and quality assurance,

109.

(1991) Providing integrated employment opportunities for persons with disabilities, Butterworth

110.

(2002) The role of work in the recovery of persons with psychiatric disabilities,

111.

(1999) Getting back to work Self-efficacy as a predictor of employment outcome,

112.

(1997) Prediction of vocational outcome based on clinical and demographic indicators among vocationally ready clients,

113.

(1988) Psychiatric rehabilitation as the preferred response to the needs of individuals with severe psychiatric disability,

114.

(1992) Survey of client preferences for vocational and educational services Center for Psychiatric Rehabilitation, Unpublished manuscript Boston University

115.

(1994) How psychiatric disability expresses itself as a barrier to employment,

116.

(1993) Situational assessment ratings of work behaviors Changes across time and between settings,

117.

(2000) Recovery from severe psychiatric disability Finding of a qualitative study,

118.

(1991) Community services for adults with disabilities Policy challenges in emerging support paradigm Critical issues in the lives of people with severe disabilities, Brooks Publishing Co

119.

(1997) How do man with schizophrenia fare at work A follow-ut study from India,

120.

(1998) Meaningful work in supportive environments Experiments with the recovery process,

121.

(1980) An alternative to mental health treatment Archives of General Psychiatriy,

122.

(1995October) Impact of seven years of assertive community treatment,

123.

(1995) Rehabilitation day treatment vs. supported employment Consumer, family, and staff reactions to a program change,

124.

(1998) Address the social needs of mental health consumers when they treatment programs convert to supported employment Can consumer-run services play a role? ,

125.

(1988) An innovative approach to the vocational rehabilitation of persons who are psychiatrically disabled,

126.

(1996) A conceptual framework for work-related social skills in psychiatric rehabilitation ,

127.

(1994) Access to educational programs and its effect on employability,

128.

(2002) Outcome measures across program sites for postsecondary supported education programs,

129.

(1996) Quality of life and self-esteem in working and nonworking persons with mental illness,

130.

(1999) Teaching fundamental workplace skills to persons with serious mental illness,

131.

(1995) Mental health and vocational rehabilitation collaboration: Local strategies that work,

132.

(1997) Job tenure among persons with severe mental illness,

133.

(1990) Employment programing and psychiatric disabilities, New Directions for Mental Health Services

134.

(1999) Exploring recovery from the perspective of people with psychiatric disabilities,

135.

(1993) Reasonable accommodations for people with mental illness under the ADA,

136.

(1993) Reasonable accommodations for people with mental illness under the ADA,

Korean Journal of Clinical Psychology